Profil pressionnel de l’adolescent en milieu scolaire à Lubumbashi, République Démocratique du Congo

Introduction: L'objectif de cette étude était de donner le profil de la pression artérielle (PA) des adolescents âgés de 15 à 19 ans en milieu scolaire à Lubumbashi, République Démocratique du Congo. Méthodes: il s'agit d'une étude transversale, portant sur les adolescents âgés de 15 à 19 ans au moyen d'un échantillonnage aléatoire des écoles secondaires de Lubumbashi durant les années scolaires 2013-2014, 2014-2015 et 2015-2016. Trois mesures de PA étaient effectuées le même jour. Résultats: 1766 adolescents âgés de 15-19 ans ont été inclus parmi eux 995 étaient de sexe féminin et 771 garçons. Les garçons avaient significativement une pression artérielle systolique élevée que les filles dans les tranches d'âges de 17, 18 et 19 ans. La pression artérielle diastolique n'était pas différente statistiquement dans toutes les tranches d'âges dans les deux sexes. Par contre, dans les deux sexes, la pression artérielle systolique été en corrélation significative avec le poids, la taille, l'indice de masse corporelle, le tour de taille et la fréquence cardiaque. Quant à la pression artérielle diastolique, des corrélations significatives étaient retrouvées avec le poids et l'indice de masse corporelle chez les filles alors que la fréquence cardiaque était en corrélation significative dans les deux sexes. Conclusion: Malgré les faiblesses potentielles de la présente étude dans sa conception transversale et les mesures de la PA le même jour, les données pourraient aider les responsables de la santé à adopter une stratégie nationale de prévention de l'hypertension artérielle dans notre population

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Active illumination and computational Methods for Temporal and Spectral Super-Resolution Microscopy

Light microscopy is a tool of paramount importance for biologists and has been constantly improved for the past four centuries. Despite many recent developments, microscopy techniques still require improvement, especially to reach better temporal and spectral resolutions. In particular, many high-end microscopes favor mostly spatial resolution, at the expense of the latter two types of resolution. In this thesis, we present methods based on the use of active illumination and computational algorithms to increase temporal and spectral resolutions of microscopes. Our methods aim to provide users with the flexibility to chose, within a single instrument, which type of resolution is to be favored based on the application at hand. More generally, our approach has fundamental implications on the signal sensing procedure, allowing, for example, to mitigate temporal aliasing in sequences of images. Our first method performs temporal super-resolution imaging of monochrome scenes using a hue-encoded shutter. By making use of an active multi-spectral illumination, temporal information is encoded in the hue of the acquisitions. We characterize the method showing a resolution improvement of 2.8 and an increase of frame-rate of a factor 3. We demonstrate the applicability of our method to bright-field transmission microscopy by applying the method to the beating heart of a zebrafish.We then extend this method to fluorescence microscopy. We add a temporal regularization term to make the method robust to fluorescent labelings inhomogeneities. We present an application of the method to the beating heart of a zebrafish that emits fluorescent light of two different colors. Implementing our method within a light-sheet microscope allows us to reconstruct 3D+time videos of the beating heart at twice the acquisition frame-rate. Our second method offers a way to perform temporal generalized sampling by computing simultaneous inner products with the sampled signal. Similarly to the first method, we take advantage of working with multiple illumination hues to compute as many simultaneous inner products, which we retrieve via an unmixing procedure. We use equivalent basic and dual B-splines representations to ensure having finite-length and positive pre-filters, as well as finite-support reconstruction functions. We show applications of our method to a fast rotating target, as well as to the beating heart of a zebrafish, both in transmission and fluorescence microscopy. Finally, we introduce a method to perform spectral imaging of repeating processes, such as the beating heart. The method sequentially acquires multiple movies with various filters, performs temporal registration of all movies and reconstructs a spectral movie through solving of a spectral unmixing problem, pixel by pixel, at each time point. We characterize the method and show a median error of approximately 10\%, by comparing reconstructions on a static sample from our method with measurements obtained with a spectrometer. We then perform validation by comparing static reconstructions with dynamic ones of the same sample. We demonstrate the potential of the method to microscopy by performing spectral imaging of the beating heart of a zebrafish. Taken together, these methods offer a versatile toolbox to improve the temporal or spectral resolution in both bright field and fluorescence microscopy, which we foresee could be directly implemented in a number of specialized instruments

Aliasing mitigation in optical microscopy of dynamic biological samples by use of temporally modulated color illumination and a standard RGB camera

Significance: Despite recent developments in microscopy, temporal aliasing can arise when imaging dynamic samples. Modern sampling frameworks, such as generalized sampling, mitigate aliasing but require measurement of temporally overlapping and potentially negative-valued inner products. Conventional cameras cannot collect these directly as they operate sequentially and are only sensitive to light intensity.Aim: We aim to mitigate aliasing in microscopy of dynamic monochrome samples by implementing generalized sampling via the use of a color camera and modulated color illumination.Approach: We solve the overlap problem by spectrally multiplexing the acquisitions and using (positive) B-spline segments as projection kernels. Reconstruction involves spectral unmixing and inverse filtering. We implemented this method using a color LED illuminator. We evaluated its performance by imaging a rotating grid and its applicability by imaging the beating zebrafish embryo heart in transmission and light-sheet microscopes.Results: Compared to stroboscopic imaging, our method mitigates aliasing with performance improving as the projection order increases. The approach can be implemented in conventional microscopes but is limited by the number of available LED colors and camera channels.Conclusions: Generalized sampling can be implemented via color modulation in microscopy to mitigate temporal aliasing. The simple hardware requirements could make it applicable to other optical imaging modalities. (C) The Authors

Architecture of a decision support system to improve clinicians' interpretation of abnormal liver function tests

The objective of this work was to create a self-working computerized clinical decision support system (CDSS) able to analyze liver function tests (LFTs) in order to provide diagnostic suggestions and helpful care support to clinicians. We developed an expert system that processes exclusively para-clinical information to provide diagnostic propositions. Drugs are a major issue in dealing with abnormal LFTs, therefore we created a drug-disease causality assessment tool to include drugs in the differential diagnosis. Along with the results, the CDSS will guide clinicians in the care process offering them case-specific support in the form of guidelines, order sets and references to recent articles. The CDSS will be implemented in Geneva University Hospitals clinical information system (CIS) during year 2011. For the time being, preliminary tests have been conducted on case reports chosen randomly on Pubmed. Considered as medical challenges, case reports were nevertheless processed correctly by the program to the extent that 18 cases out of 20 were diagnosed accurately

Temporal Super-Resolution Microscopy Using a Hue-Encoded Shutter

Limited time-resolution in microscopy is an obstacle to many biological studies. Despite recent advances in hardware, digital cameras have limited operation modes that constrain frame-rate, integration time, and color sensing patterns. In this paper, we propose an approach to extend the temporal resolution of a conventional digital color camera by leveraging a multi-color illumination source. Our method allows imaging single-hue objects at increased frame-rate by trading spectral for temporal information (while retaining the ability to measure base hue). It also allows rapid switching to standard RGB acquisition. We evaluated the feasibility and performance of our method via experiments with mobile resolution targets. We observed a time-resolution increase by a factor 2.8 with a three-fold increase in temporal sampling rate. We further illustrate the use of our method to image the beating heart of a zebrafish larva, allowing the display of color or fast grayscale images. Our method is particularly well-suited to extend the capabilities of imaging systems where the flexibility of rapidly switching between high frame rate and color imaging are necessary

Temporal resolution doubling in fluorescence light-sheet microscopy via a hue-encoded shutter and regularization

Studying dynamic biological processes, such as heart development and function in zebrafish embryos, often relies on multi-channel fluorescence labeling to distinguish multiple anatomical features, yet also demands high frame rates to capture rapid cell motions. Although a recently proposed method for imaging dynamic samples in transmission or reflection allows to conveniently switch between color imaging or boosting the frame rate by use of spectrally-encoded, temporally-modulated illumination sequences and a hue-encoded shutter (hue-encode shutter method, HESM), the technique is not applicable directly in fluorescence microscopy, where the emitted light spectrum is mostly independent of the excitation wavelength. In this paper, we extend HESM by using samples labeled with multiple fluorophores, whose emission signal can either be used to distinguish multiple anatomical features when imaged in multi-channel mode or, if the fluorophores are co-localized in a dynamic tissue, to increase the frame rate via HESM. We detail the necessary steps to implement this method in a two-color light-sheet microscope to image the beating heart of a zebrafish embryo. Specifically, we propose an adapted laser modulation scheme for illumination, we identify caveats in choosing a suitable multi-color fluorophore labeling strategy, and derive an l(1)-regularized reconstruction technique that is sufficiently robust to handle the low signal-to-noise ratio and labeling inhomogeneities in the fluorescence images at hand. Using the case of a beating heart in a zebrafish embryo, we experimentally show an increase in the frame rate by a factor two while preserving the ability to image static features labeled in distinct channels, thereby demonstrating the applicability of HESM to fluorescence. With a suitable illumination setup and fluorescent labeling, the method could generalize to other applications where flexibility between multiple channel and high-speed fluorescence imaging is desirable. For fluorophores that are not co-localized, the imaging system is similar to a conventional light sheet microscope. (c) 2020 Optical Society of America under the terms of the OSA Open Access Publishing Agreemen

Comment les déterminants de la participation de la personne âgée de 75 ans et plus, alcoolique et résidant en établissement médico-social (EMS), influencent-ils l'alliance thérapeutique ?

La gestion de l’addiction à l’alcool chez les résident(e)s âgé(e)s de 75 ans et plus est l’un des problèmes complexes que doivent gérer les établissements de soins médico-sociaux (EMS). En effet, l’addiction à différentes substances reste un problème de santé actuel dans la population suisse. Plus spécifiquement, la consommation quotidienne d’alcool est une problématique qui concerne 9.4% de la population. Ce taux tend à augmenter avec l’âge et représente plus de 26.2% chez les séniors de 75 ans et plus. Les comportements addictifs à l’alcool, et notamment chez la personne âgée, entraînent des risques et des répercussions sur l’état de santé. L’alliance thérapeutique entre l’infirmière et le patient, ainsi que ses déterminants, vont avoir un impact sur le suivi du traitement et la consommation d’alcool